Excessive Tibial Rotation During High-Demand Activities Is Not Restored by Anterior Cruciate Ligament Reconstruction

Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up

“…But as there is a variety of possible tools for measuring the rotational stability in the lab, the manual pivot shift test still remains the only validated parameter in the daily clinical routine. Even if there is an attempt of an objective quantitative measurement by several technical devices [17][18][19][20], objective quantitative assessment of the pivot shift phenomenon is currently lacking and the evaluation greatly depends on the examiner's subjective experience and impression [21,22]. Therefore, accurate assessment of the pivot shift is essential to obtain an exact clinical assessment of ACL-deficient or reconstructed knee.…”

Femoral Tunnel Placement in Single-Bundle Anterior Cruciate Ligament Reconstruction

“…Recently, several authors have shown increasing functional instability and degenerative radiographic changes after single-bundle ACL reconstruction. 20,30,35 The current trend in ACL reconstruction techniques is to more closely restore the anatomical footprint and kinematics of the ACL through a more laterally positioned femoral tunnel, which replaces portions of both the PL and AM bundles. 10,25 Clinical outcome studies in patients using lateralized single-bundle femoral tunnel ACL reconstruction techniques have yielded good results.…”

Effect of Femoral Tunnel Placement for Reconstruction of the Anterior Cruciate Ligament on Tibial Rotation

“…This parameter is measured clinically with the Lachman test or the anterior drawer test 1 . However, rotational knee movement after injury and reconstruction of the anterior cruciate ligament is difficult to quantify [2][3][4][5][6][7] . The only clinical test for examining rotation is the pivot-shift test, which is a subjective static measurement that can mask small rotational differences between the intact and the reconstructed knee.…”

“…The only clinical test for examining rotation is the pivot-shift test, which is a subjective static measurement that can mask small rotational differences between the intact and the reconstructed knee. Thus, various researchers have assessed dynamic knee movement during activities of daily living in order to quantify rotation following reconstruction of the anterior cruciate ligament [2][3][4][5][6][7] . Such assessments are crucial because it has been reported recently that abnormal rotational movements of knees treated with reconstruction of the anteDisclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants of less than $10,000 from the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST-EEXOT).…”